Abstract：
BACKGROUND: Upper extremity musculoskeletal injuries are common with active-duty Army Soldiers and result in increased limited duty days. Patient satisfaction and surgery rates improve with direct access to occupational therapy in the civilian community.
OBJECTIVE: Examine the amount of time from initial evaluation following an upper extremity musculoskeletal injury (MSKI) to return to full duty plus occupational therapy (OT) utilization in Army Soldiers.
METHODS: Retrospective observational.
METHODS: Electronic health records and profiles from 18,206 US active-duty Army soldiers with MSKI and OT evaluation between 2017-2018 were examined. Repeated measures generalized estimating equations provided the rate ratios (RRs) for OT healthcare utilization (total number of OT evaluations and treatment visits) by days to first OT evaluation and limited duty profile (total days on profile).
RESULTS: Soldiers were on average 32.0 (SD = 8.9) y/o, predominantly senior enlisted (45.7%), white (58.0%), male (81.4%), 10.0 (SD = 8.4) years of service, and high school or less educated (51.3%). There were 22,617 UE MSKIs with an OT evaluation and 4936 UE MSKIs with profiles. Compared with UE MSKIs with an OT evaluation on the same day, there was a significant increase in rates of OT utilization for 1-7 days (RR: 1.4, 95% CI: 1.3, 1.5), 8-14 days (RR: 1.3, 95% CI: 1.2, 1.4), 15-30 days (RR: 1.4, 95% CI: 1.3, 1.5), 31-60 days (RR: 1.5, 95% CI: 1.4, 1.6), and +60 days later (RR: 1.6, 95% CI: 1.5, 1.7). Similar differences in rates for limited duty profiles were found.
CONCLUSIONS: A greater number of days between diagnosis of UE MSKI and OT evaluation results in greater rates of OT utilization and longer temporary profile. Results suggest that earlier intervention by OT may decrease recovery and healthcare utilization of soldiers.
OBJECTIVE: Examine the amount of time from initial evaluation following an upper extremity musculoskeletal injury (MSKI) to return to full duty plus occupational therapy (OT) utilization in Army Soldiers.
METHODS: Retrospective observational.
METHODS: Electronic health records and profiles from 18,206 US active-duty Army soldiers with MSKI and OT evaluation between 2017-2018 were examined. Repeated measures generalized estimating equations provided the rate ratios (RRs) for OT healthcare utilization (total number of OT evaluations and treatment visits) by days to first OT evaluation and limited duty profile (total days on profile).
RESULTS: Soldiers were on average 32.0 (SD = 8.9) y/o, predominantly senior enlisted (45.7%), white (58.0%), male (81.4%), 10.0 (SD = 8.4) years of service, and high school or less educated (51.3%). There were 22,617 UE MSKIs with an OT evaluation and 4936 UE MSKIs with profiles. Compared with UE MSKIs with an OT evaluation on the same day, there was a significant increase in rates of OT utilization for 1-7 days (RR: 1.4, 95% CI: 1.3, 1.5), 8-14 days (RR: 1.3, 95% CI: 1.2, 1.4), 15-30 days (RR: 1.4, 95% CI: 1.3, 1.5), 31-60 days (RR: 1.5, 95% CI: 1.4, 1.6), and +60 days later (RR: 1.6, 95% CI: 1.5, 1.7). Similar differences in rates for limited duty profiles were found.
CONCLUSIONS: A greater number of days between diagnosis of UE MSKI and OT evaluation results in greater rates of OT utilization and longer temporary profile. Results suggest that earlier intervention by OT may decrease recovery and healthcare utilization of soldiers.
摘要：
背景：上肢肌肉骨骼损伤在现役陆军士兵中很常见，并导致有限的值班天数增加。患者满意度和手术率随着平民社区直接获得职业治疗而提高。
目的：检查从上肢肌肉骨骼损伤（MSKI）后的初步评估到恢复陆军士兵全勤加职业治疗（OT）的时间。
方法：回顾性观察。
方法：检查了2017-2018年间18,206名美国现役军人的电子健康记录和档案，并进行了MSKI和OT评估。重复测量的广义估计方程提供了按首次OT评估和有限职责概况（总天数）的OT医疗保健利用率比率（RR）（OT评估和治疗访问的总数）。
结果：士兵平均为32.0（SD=8.9）y/o，主要是高级入伍(45.7%)，白色（58.0%），男性（81.4%），10.0（标准差=8.4）年的服务，高中或文化程度较低(51.3%)。有22,617个具有OT评估的UEMSKI和4936个具有配置文件的UEMSKI。与当天进行OT评估的UEMSKIs相比，1-7天的OT利用率显着增加（RR：1.4，95％CI：1.3，1.5），8-14天（RR：1.3，95%CI：1.2，1.4），15-30天（RR：1.4，95%CI：1.3，1.5），31-60天（RR：1.5，95%CI：1.4，1.6），60天后（RR：1.6，95%CI：1.5，1.7）。在有限的任务概况中发现了类似的比率差异。
结论：在UEMSKI诊断和OT评估之间的天数越多，OT利用率就越高，临时情况也越长。结果表明，OT的早期干预可能会降低士兵的康复和医疗保健利用率。
目的：检查从上肢肌肉骨骼损伤（MSKI）后的初步评估到恢复陆军士兵全勤加职业治疗（OT）的时间。
方法：回顾性观察。
方法：检查了2017-2018年间18,206名美国现役军人的电子健康记录和档案，并进行了MSKI和OT评估。重复测量的广义估计方程提供了按首次OT评估和有限职责概况（总天数）的OT医疗保健利用率比率（RR）（OT评估和治疗访问的总数）。
结果：士兵平均为32.0（SD=8.9）y/o，主要是高级入伍(45.7%)，白色（58.0%），男性（81.4%），10.0（标准差=8.4）年的服务，高中或文化程度较低(51.3%)。有22,617个具有OT评估的UEMSKI和4936个具有配置文件的UEMSKI。与当天进行OT评估的UEMSKIs相比，1-7天的OT利用率显着增加（RR：1.4，95％CI：1.3，1.5），8-14天（RR：1.3，95%CI：1.2，1.4），15-30天（RR：1.4，95%CI：1.3，1.5），31-60天（RR：1.5，95%CI：1.4，1.6），60天后（RR：1.6，95%CI：1.5，1.7）。在有限的任务概况中发现了类似的比率差异。
结论：在UEMSKI诊断和OT评估之间的天数越多，OT利用率就越高，临时情况也越长。结果表明，OT的早期干预可能会降低士兵的康复和医疗保健利用率。
